Ascension St. John Medical Center (St. John Medical Center, Inc.)
1923 S Utica Ave, Tulsa, OK · Ascension · · NPI 1154417368
Published prices by procedure
Cash price is what you pay without insurance. The negotiated range spans the lowest to highest rate this hospital agreed with insurers.
| Procedure | Cash price | Gross charge | Negotiated range | Payers |
|---|---|---|---|---|
| Cytarabine 20 mg/ml injection solution HCPCS J9100 | $28.25 | $76.35 | $9.27 – $9.27 | 5 |
| Cytogenetics 25-99 CPT 88274 | not published | not published | $36.74 – $169.52 | 30 |
| Cytogenetics 3-5 CPT 88272 | not published | not published | $28.14 – $162.80 | 30 |
| Cytogenomic neo microra alys CPT 81277 | not published | not published | $1,316.60 – $1,316.60 | 1 |
| Cytogenom microarray copy nmbr var CPT 81228 | $629.65 | $1,701.75 | $74.21 – $3,600.00 | 29 |
| Cytomegalovirus (cmv) antibody igg CPT 86644 | $49.03 | $132.50 | $14.39 – $57.56 | 30 |
| Cytomegalovirus (cmv) antibody igm CPT 86645 | $49.40 | $133.50 | $16.85 – $67.40 | 30 |
| Cytomegalovirus dfa CPT 87271 | not published | not published | $12.77 – $53.68 | 30 |
| Cytomegalovirus imm IV /vial HCPCS J0850 | $941.58 | $2,544.80 | $1,297.26 – $1,297.26 | 5 |
| Cyto/molecular report CPT 88291 | $235.90 | $637.57 | $22.84 – $65.51 | 7 |
| Cytopath c/v auto in fluid CPT 88174 | not published | not published | $18.11 – $101.48 | 30 |
| Cytopath c/v index add-on CPT 88155 | not published | not published | $6.25 – $58.60 | 30 |
| Cytopath fl nongyn filter CPT 88106 | not published | not published | $22.24 – $171.60 | 30 |
| Cytopathology cellular enhancement technique non-gyn CPT 88112 | $47.64 | $128.75 | $32.18 – $203.28 | 30 |
| Cytopathology cervical/vaginal thin layer auto screen/manual rescreen/review CPT 88175 | not published | not published | $22.83 – $106.44 | 30 |
| Cytopathology cervical/vaginal thin layer manual screening CPT 88142 | not published | not published | $18.74 – $81.04 | 30 |
| Cytopathology concentration technique smears & interpretation CPT 88108 | $48.56 | $131.25 | $22.24 – $149.36 | 30 |
| Cytopathology fluids/washings/brushings smears with interpretation CPT 88104 | $40.70 | $110.00 | $22.24 – $149.36 | 30 |
| Cytopathology fna adequacy evaluation each separate additional episode same site CPT 88177 | $27.29 | $73.75 | $7.55 – $62.40 | 6 |
| Cytopathology fna adequacy evaluation first episode each site CPT 88172 | $26.92 | $72.75 | $16.02 – $652.00 | 30 |
| Cytopathology fna adequacy evaluation first episode each site interp/rpt CPT 88173 | $73.26 | $198.00 | $45.73 – $203.28 | 30 |
| Cytopath smear other source CPT 88160 | $41.07 | $111.00 | $19.15 – $106.02 | 30 |
| Cytopath smear other source CPT 88162 | $55.50 | $150.00 | $28.53 – $203.28 | 30 |
| Cytopath smear oth prep screen & interp CPT 88161 | $32.75 | $88.50 | $19.62 – $124.03 | 30 |
| Cytopath tbs c/v manual CPT 88164 | not published | not published | $11.20 – $72.76 | 30 |
| Cytotoxic antibody screening CPT 86807 | $184.63 | $499.00 | $41.69 – $314.60 | 30 |
| Cytotoxic antibody screening CPT 86808 | not published | not published | $29.68 – $118.72 | 30 |
| Cytp urine 3-5 probes cmptr CPT 88121 | not published | not published | $163.00 – $1,106.06 | 29 |
| Dacarbazine 100 mg intravenous solution HCPCS J9130 | $29.80 | $80.55 | $19.78 – $19.78 | 5 |
| Dactinomycin 0.5 mg intravenous solution HCPCS J9120 | $803.44 | $2,171.45 | $648.99 – $648.99 | 5 |
| Dalbavancin 500 mg intravenous solution HCPCS J0875 | $2,077.81 | $5,615.70 | $21.28 – $22.80 | 5 |
| Dalteparin sodium HCPCS J1645 | $55.19 | $149.15 | $19.78 – $19.78 | 5 |
| Daptomycin 500 mg/10 ml intravenous solution HCPCS J0878 | $0.58 | $1.57 | $0.88 – $0.88 | 5 |
| Darbepoetin alfa 100 mcg/0.5 ml in polysorbate injection syringe HCPCS J0881 | $556.33 | $1,503.60 | $19.78 – $19.78 | 5 |
| Daunorubicin 44 mg and cytarabine 100 mg in liposome IV solution HCPCS J9153 | $11,312.75 | $30,575.00 | $259.07 – $277.58 | 4 |
| Daunorubicin 5 mg/ml intravenous solution HCPCS J9150 | $130.13 | $351.70 | $15.24 – $19.78 | 6 |
| Dbrdmt prmlg les w/pdt CPT 96574 | not published | not published | $189.01 – $756.04 | 23 |
| D&c after delivery 59160 CPT 59160 | $3,273.85 | $8,848.25 | $193.77 – $323.81 | 7 |
| D&c/diagnostic/therapeutic/non ob 58120 CPT 58120 | not published | not published | $241.79 – $410.87 | 7 |
| Dch glucoscan CPT 82948 | not published | not published | $3.39 – $20.16 | 30 |
| Dch pulmonary stress test CPT 94621 | $246.61 | $666.50 | $87.07 – $1,184.84 | 30 |
| Dch validity tests CPT 81002 | $18.59 | $50.25 | $2.61 – $13.92 | 30 |
| Dcm pq ndl dsk sgl/mlt lv lmbr w/guide CPT 62287 | not published | not published | $620.72 – $1,058.48 | 7 |
| Dcmprn orbit only transcrnl CPT 61330 | not published | not published | $1,755.28 – $3,366.56 | 7 |
| Dcmprn plantar digital nerve CPT 64726 | not published | not published | $302.10 – $510.87 | 7 |
| D&c of cervical stump CPT 57558 | not published | not published | $124.10 – $213.60 | 7 |
| Deamidated gliadin antibody iga CPT 86258 | not published | not published | $12.05 – $48.20 | 23 |
| Debr g/per/abd wall 11006 CPT 11006 | not published | not published | $798.10 – $1,311.53 | 7 |
| Debrid ecz/inf skin up tp 10% body 11000 CPT 11000 | $555.65 | $1,501.75 | $32.38 – $2,329.08 | 30 |
| Debridement (>20 cm) charge pt CPT 97598 | $186.76 | $504.75 | $12.30 – $146.29 | 7 |
| Debridement bone <= 20 sq cm CPT 11044 | $1,036.00 | $2,800.00 | $259.11 – $436.04 | 7 |
| Debridement/bone/20 sq cm or less 11046 CPT 11046 | $363.80 | $983.25 | $63.29 – $104.76 | 6 |
| Debridement/bone/ea add 20 sq cm 11047 CPT 11047 | $1,283.44 | $3,468.75 | $112.38 – $185.03 | 6 |
| Debridement subcutaneous tissue <= 20 sq cm CPT 11042 | $406.35 | $1,098.25 | $53.29 – $1,520.16 | 30 |
| Debride nail1-5 11720 CPT 11720 | $110.35 | $298.25 | $16.64 – $226.00 | 30 |
| Debride nail6 or more 11721 CPT 11721 | $64.84 | $175.25 | $28.14 – $226.00 | 30 |
| Debride/rmv fb/open fx/skin/sq/musc11011 CPT 11011 | $567.77 | $1,534.50 | $335.25 – $2,677.08 | 30 |
| Debride skin bone at fx site CPT 11012 | $2,379.93 | $6,432.25 | $475.94 – $783.65 | 7 |
| Debride skn/sq/musc/abd wall 11004 CPT 11004 | not published | not published | $655.52 – $1,076.84 | 7 |
| Debride skn/sq t/m/f necro infctj abdl wall 11005 CPT 11005 | not published | not published | $872.44 – $1,452.33 | 7 |
| Debride/subq tissue/ea add 20sq cm 11045 CPT 11045 | $363.80 | $983.25 | $29.40 – $51.02 | 6 |
| Debrid mastoidectomy cavity simple 69220 CPT 69220 | not published | not published | $57.25 – $756.04 | 30 |
| Debrid/rmv fgn bdy/open fx/skin/sq 11010 CPT 11010 | $847.49 | $2,290.50 | $315.09 – $2,677.08 | 30 |
| Debr inf skin add-on 11001 CPT 11001 | $280.00 | $756.75 | $16.20 – $27.21 | 7 |
| Debr musc/fascia 20sq cm/< 11043 CPT 11043 | $381.66 | $1,031.50 | $174.22 – $2,329.08 | 30 |
| Decalcification CPT 88311 | $7.31 | $19.75 | $6.67 – $42.90 | 7 |
| Decitabine 50 mg intravenous solution HCPCS J0894 | $81.81 | $221.10 | $185.43 – $185.43 | 5 |
| Declotting thrombolytic agent implanted vas access device 36 CPT 36593 | $165.58 | $447.50 | $31.98 – $1,262.04 | 30 |
| Decomp fasct leg ant+/lat+pst cmprt 27602 CPT 27602 | not published | not published | $545.80 – $935.34 | 7 |
| Decomp forearm 1 space 25020 CPT 25020 | not published | not published | $608.94 – $1,053.03 | 7 |
| Decomp forearm 2 spaces w/debrid 25025 CPT 25025 | not published | not published | $1,299.86 – $2,259.11 | 7 |
| Decompress fasciotomyhand 26037 CPT 26037 | not published | not published | $614.68 – $1,048.26 | 7 |
| Decompress fingers/hand CPT 26035 | not published | not published | $890.74 – $1,575.47 | 7 |
| Decompress forearm 1 space CPT 25023 | not published | not published | $1,187.66 – $2,040.75 | 7 |
| Decompress forearm 2 spaces CPT 25024 | not published | not published | $837.22 – $1,447.58 | 7 |
| Decompression fasct forearm CPT 24495 | not published | not published | $591.52 – $1,183.64 | 7 |
| Decompression of leg CPT 27892 | not published | not published | $603.44 – $1,022.42 | 7 |
| Decompression of leg CPT 27893 | not published | not published | $609.93 – $1,126.50 | 7 |
| Decompression of leg CPT 27894 | not published | not published | $939.70 – $1,616.96 | 7 |
| Decompression of lower leg CPT 27600 | not published | not published | $451.65 – $774.12 | 7 |
| Decompression of lower leg CPT 27601 | not published | not published | $482.56 – $821.06 | 7 |
| Decompression of thigh/knee CPT 27496 | not published | not published | $545.82 – $997.92 | 7 |
| Decompression of thigh/knee CPT 27497 | not published | not published | $596.49 – $1,070.04 | 7 |
| Decompression of thigh/knee CPT 27498 | not published | not published | $651.28 – $1,202.00 | 7 |
| Decompression of thigh/knee CPT 27499 | not published | not published | $721.64 – $1,287.72 | 7 |
| Decompression of tibia nerve CPT 28035 | not published | not published | $393.11 – $662.57 | 7 |
| Decompression unspecified nerve 64722 CPT 64722 | not published | not published | $365.48 – $672.77 | 7 |
| Decompressive craniotomy CPT 61322 | not published | not published | $2,514.46 – $4,340.00 | 7 |
| Decompress optic nerve CPT 67570 | not published | not published | $1,167.68 – $2,306.06 | 7 |
| Decompres spinal cord;thoracic 63055 CPT 63055 | not published | not published | $1,769.70 – $2,980.17 | 7 |
| Decompress small bowel CPT 44021 | not published | not published | $1,069.81 – $1,812.18 | 7 |
| Decompress spinal cord lmbr CPT 63056 | not published | not published | $1,634.63 – $2,726.45 | 7 |
| Decompress spinal cord thrc CPT 63064 | not published | not published | $1,938.32 – $3,245.48 | 7 |
| Decomp spinal cord/transped/ad seg 63057 CPT 63057 | not published | not published | $363.04 – $591.83 | 7 |
| Deep muscle biopsy 20205 CPT 20205 | not published | not published | $166.11 – $285.03 | 7 |
| Deferoxamine 500 mg solution for injection HCPCS J0895 | $23.75 | $64.20 | $19.78 – $19.78 | 5 |
| Degarelix 120 mg subcutaneous solution HCPCS J9155 | $30.47 | $82.35 | $19.78 – $19.78 | 5 |
| Delayed breast prosthesis 19342 CPT 19342 | not published | not published | $997.75 – $1,718.99 | 7 |
| Delay flap arms/legs CPT 15610 | not published | not published | $251.57 – $445.56 | 7 |
| Delay flap eye/nos/ear/lip CPT 15630 | not published | not published | $366.57 – $645.56 | 7 |
A missing value means the hospital did not publish that price — it never means the price is zero. Real bills can add facility fees, supplies and professional fees; see our methodology.